{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:46:07Z","timestamp":1774435567441,"version":"3.50.1"},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>There have been significant reductions in the burden of trachoma worldwide. However, some districts have experienced persistently high trachoma prevalence despite many years of intervention. Here, we report the epidemiology of trachoma in Merhabete, Ethiopia, a district in the Amhara Region that has been receiving azithromycin mass drug administration (MDA) since 2009. Data were obtained from the baseline survey of a cluster randomized trial evaluating targeted treatment strategies for trachoma elimination. An enumerative census was conducted in February 2022 to generate lists of children aged 6 months to 9 years in 80 sentinel communities participating in the trial. All children in the sentinel communities who were included in the census were examined. Field grades and conjunctival swabs were collected to assess active trachoma (based on clinical assessment) and ocular chlamydia (based on polymerase chain reaction to identify <jats:italic>Chlamydia trachomatis<\/jats:italic>). A total of 5,935 children were examined in 80 communities. The prevalence of trachomatous inflammation\u2014follicular (TF) was 46.6%, trachomatous inflammation\u2014intense (TI) was 17.5%, and ocular chlamydia was 28.0%. The correlation between TF and ocular chlamydia (correlation coefficient 0.54, 95% CI 0.34\u20130.70) was similar to the correlation between TI and ocular chlamydia (correlation coefficient 0.49, 95% CI 0.30\u20130.65). The prevalence of ocular chlamydia remained high in this district, which had received more than 10 rounds of azithromycin MDA. Ocular chlamydia was moderately correlated with both TF and TI. Intensive interventions may be required to eliminate trachoma in settings with persistently high ocular chlamydia prevalence despite many years of intervention.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0732","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T15:45:34Z","timestamp":1741103134000},"page":"1091-1095","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of Ocular Chlamydia trachomatis and Active Trachoma among Children in Merhabete District, Amhara, Ethiopia"],"prefix":"10.4269","volume":"112","author":[{"given":"Awraris","family":"Hailu Bilchut","sequence":"first","affiliation":[{"name":"Debre Berhan University, Debre Berhan, Ethiopia;"},{"name":"Eyu-Ethiopia, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmael","family":"Habtamu","sequence":"additional","affiliation":[{"name":"Eyu-Ethiopia, Bahir Dar, Ethiopia;"},{"name":"International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom;"},{"name":"College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeshigeta","family":"Gelaw","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aemero","family":"Abateneh","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belay","family":"Beyene","sequence":"additional","affiliation":[{"name":"Amhara Public Health Institute, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambahun","family":"Chernet","sequence":"additional","affiliation":[{"name":"Amhara Public Health Institute, Bahir Dar, Ethiopia;"},{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tariku","family":"Wondie","sequence":"additional","affiliation":[{"name":"Eyu-Ethiopia, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adisu","family":"Abebe","sequence":"additional","affiliation":[{"name":"Amhara Regional Health Bureau, Bahir Dar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyu","family":"Hu","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadley","family":"Burroughs","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoxia","family":"Zhao","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Shantha","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Nash","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, Georgia;"},{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin F.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Lietman","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"},{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine E.","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"},{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"N Engl J Med","first-page":"1962","article-title":"Mass treatment with single-dose azithromycin for trachoma","volume":"351","author":"Solomon","year":"2004"},{"key":"b2","series-title":"JAMA","first-page":"1142","article-title":"Effect of a single mass antibiotic distribution on the prevalence of infectious trachoma","volume":"295","author":"Chidambaram","year":"2006"},{"key":"b3","series-title":"Nat Rev Dis Primers","first-page":"32","article-title":"Trachoma","volume":"8","author":"Solomon","year":"2022"},{"key":"b4","series-title":"Wkly Epidemiol Rec 2019","first-page":"317","article-title":"WHO Alliance for the Global Elimination of Trachoma by 2020: Progress report on elimination of trachoma","volume":"29","year":"2018"},{"key":"b5","series-title":"AM J Trop Med Hyg","first-page":"1286","article-title":"Progress to eliminate trachoma as a public health problem in Amhara National Regional State, Ethiopia: Results of 152 population-based 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Hyg","first-page":"1278","article-title":"Twelve-year longitudinal trends in trachoma prevalence among children aged 1\u20139 years in Amhara, Ethiopia, 2007\u20132019","volume":"104","author":"Sata","year":"2021"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"105","article-title":"The epidemiology of ocular Chlamydia trachomatis infection within districts persistently endemic for trachoma in Amhara, Ethiopia","volume":"111","author":"Nash","year":"2024"},{"key":"b11","series-title":"Bull World Health Organ","first-page":"698","article-title":"The simplified trachoma grading system, amended","volume":"98","author":"Solomon","year":"2020"},{"key":"b12","series-title":"Ophthalmic Epidemiol","first-page":"86","article-title":"Estimating community prevalence of ocular Chlamydia trachomatis infection using pooled polymerase chain reaction testing","volume":"21","author":"Ray","year":"2014"},{"key":"b13","series-title":"Lancet Glob Health","first-page":"e87","article-title":"Water, sanitation, and hygiene for control of trachoma in Ethiopia (WUHA): A two-arm, parallel-group, cluster-randomised trial","volume":"10","author":"Aragie","year":"2022"},{"key":"b14","series-title":"Lancet","first-page":"143","article-title":"Comparison of annual versus twice-yearly mass azithromycin treatment for hyperendemic trachoma in Ethiopia: A cluster-randomised trial","volume":"379","author":"Gebre","year":"2012"},{"key":"b15","series-title":"JAMA","first-page":"721","article-title":"Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments","volume":"292","author":"Melese","year":"2004"},{"key":"b16","series-title":"Lancet Glob Health","first-page":"e491","article-title":"Global progress toward the elimination of active trachoma: An analysis of 38 countries","volume":"10","author":"Renneker","year":"2022"},{"key":"b17","series-title":"Am J Trop Med 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elimination","volume":"115","author":"Borlase","year":"2021"}],"container-title":["The American Journal of Tropical Medicine and 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